CMS Price Transparency Data

CT scan, lower back (lumbar spine)

Facility: Texas Health Presbyterian Hospital Rockwall

Billing Code: 72131 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$115

about 1.1× the $107 Medicare rate · typically $113–$260

modeled estimate · not a bill or quote

What this hospital charges insurers

$116

About the fair price

about $1 over the fair price · 1.1× Medicare

Medicare pays $107 Fair price $115 This hospital $116 Cash price $2,394 Hospital's list price $3,990

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $46 Priciest $116

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, lower back (lumbar spine) is about $115 (about 1.1× the $107 Medicare rate). Texas Health Presbyterian Hospital Rockwall charges insurers about $116, or about $2,394 in cash — about the fair price. Located in Rockwall, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$105 - $1,458	98%
Blue Cross Blue Shieldmajor	$105 - $795	98%
Aetnamajor	$916 - $2,797	858%
Cignamajor	$1,792 - $3,755	1678%
Humanamajor	$109	102%
Amerigroup	$105 - $110	98%
Cigna HealthSpring	$107	100%
Molina	$110 - $113	103%
WellCare	$110 - $116	103%
+ 6 smaller / regional plans	$105 - $3,511

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,394), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72131.

Insurance Before you use insurance

Call your insurance company to confirm Texas Health Presbyterian Hospital Rockwall is in-network.
Ask your insurer whether prior approval is required for CPT code 72131.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Texas Health Presbyterian Hospital Rockwall

Compare: CT scan, lower back (lumbar spine) at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.